In the 1990s, reforms to welfare and Federal disability insurance programs had two goals: promoting employment among traditional recipients of public income assistance and reducing dependency on public income assistance. Little is known about the impact of these reforms on individuals with substance use disorders (SUDs). This Mentored Research Scientist Award will allow Dr. Ellen Meara, a health economist with expertise in vulnerable populations, to supplement her economic tools to achieve her long-term career goal of becoming an independent investigator on the economics of substance abuse, focusing on the links between social insurance, and social and health outcomes for individuals with SUDs. The proposed training activities aim to: 1) develop an understanding of clinical aspects of SUDs and treatment;2) understand features of reforms to welfare and Supplemental Security Income and Social Security Disability Insurance (SSI/DI), and related public provision of health services;and 3) to supplement knowledge of conceptual and analytic methods relevant for studying the impact of social insurance programs on individuals with SUDs. Dr. Meara proposes to pursue these aims through coursework and tutorials with the guidance of sponsor Dr. Richard Frank, a health economist with expertise in the economics of mental health and substance abuse, co-sponsor, Dr. Shelly Greenfield, a psychiatrist and researcher specializing in addictions, and co-sponsor Dr. Thomas McGuire, a health economist with expertise in economic theory, mental health and substance abuse. The proposed research aims to: 1) determine the impact of reforms to welfare and SSI/DI on employment among low-income individuals with SUDs;2) to determine the impact of these reforms on health outcomes including: substance use and abuse, substance abuse treatment, symptoms of mental illness, and general health outcomes for individuals with SUDs;and 3) to determine how reforms to welfare and SSI/DI influence public program participation and related social costs.
